Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or New Mexico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Mexico only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. New Mexico (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Four Winds Behavioral Health, Inc. (NPI 1558799684)

Key Findings

Field	Value
Entity Type	Organization
Organization	Four Winds Behavioral Health, Inc.
Address	4100 Barbara Loop Se
City	Rio Rancho
State	NM
ZIP	87124
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 29, 2013

Payer Source	Total Paid
Medicaid	$38.2M
Medicare	$0

FOUR WINDS BEHAVIORAL HEALTH, INC. (RIO RANCHO, NM) is effectively a Medicaid-centered provider: it has $38.2M in lifetime Medicaid revenue on file and no Medicare billing reported, making its financial footprint single-payer in practice. The provider’s NPI was enumerated on 2013-10-29 (~13 years ago), indicating an established presence in the state market.

Revenue is highly concentrated in a very small set of services: the top three Medicaid codes (H0015, 80307, 90853) together account for 92.6% of this provider’s total Medicaid revenue. Individually those top codes are H0015 ($29.4M, 77.1% of Medicaid revenue), 80307 ($4.5M, 11.9%), and 90853 ($1.4M, 3.7%).

The code mix indicates an operation focused on substance use intensive outpatient programming and high-frequency drug testing: H0015 is for intensive outpatient alcohol/drug services and 80307 is for instrumented presumptive drug testing. The dominance of H0015 (245.3K claims) alongside 73.2K claims for 80307 implies a workflow centered on structured, recurring SUD treatment episodes with routine laboratory monitoring.

FOUR WINDS is a dominant statewide player for its primary service lines: H0015 ranks #1 of 54 providers in-state (100th percentile; extreme outlier), 80307 ranks #2 of 77 (99th percentile; extreme outlier), and 90853 ranks #5 of 193 (98th percentile; extreme outlier). Those rank and percentile positions signal volumes far above typical state peers for these specific codes.

Although H0015 and 80307 drive the majority of revenue, the provider also bills a range of outpatient behavioral health services at smaller scale, supporting a broader program mix. Notable examples include 90834 (10.2K claims, $824.3K revenue, 2.2% of Medicaid revenue), 90832 (3K claims, $214.9K, 0.6%), 90792 (1.5K claims, $214.2K, 0.6%), and 90791 (1.4K claims, $167.4K, 0.4%), which indicate individual psychotherapy and psychiatric evaluation activity supplementing the intensive outpatient model.

Laboratory and ancillary testing are material operational components beyond therapy: 80307 alone is 73.2K claims and $4.5M in revenue (11.9% of Medicaid revenue), and other lab codes such as 87633 ($380.4K, 1.0%) and 87798 ($30.5K, 0.1%) appear in the top-billed list. The presence of high-volume, instrumented drug testing suggests significant investment in on-site or closely affiliated lab workflows to support treatment monitoring.

The extreme concentration in a single service line (H0015 at 77.1% of revenue and the top three codes totaling 92.6%) exposes the provider’s Medicaid revenue to utilization and policy shifts tied to intensive outpatient SUD services and associated lab testing. From a payer or network-planning perspective, this pattern signals that changes to coverage, authorization, or reimbursement for those core codes could materially affect the provider’s overall revenue profile.

Operational scale is evident in claim counts: 245.3K claims for H0015 and 73.2K claims for 80307 underscore high throughput of treatment episodes and testing encounters. Combined with the provider’s ~13-year tenure, these volumes support characterization of FOUR WINDS as an established, high-volume state specialist in intensive outpatient substance use treatment and its supporting services.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	245,310	$120	$29.4M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	73,160	$60	$4.5M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	35,750	$40	$1.4M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	10,180	$80	$824.3K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1,870	$280	$514.3K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	1,000	$380	$380.4K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	3,030	$70	$214.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	1,460	$150	$214.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,410	$120	$167.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	2,670	$60	$165.5K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.

Claims Volume vs. New Mexico Distribution

Four Winds Behavioral Health, Inc. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	1	50	4,480	$150	$2.7M
H2015	Comprehensive community support services, per 15 minutes	93	120	2,640	$150	$1.2M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	2	80	3,340	$60	$595K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	114	140	130	$220	$568.5K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	293	930	910	$80	$521.6K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	11	20	790	$240	$493.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	615	960	1,010	$90	$490K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	10	30	100	$770	$447.8K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	7	30	340	$250	$395.7K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	7	20	250	$410	$330.3K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amazing Grace Personal Care Service, Inc	NM	In Home Supportive Care Agency	$0	$27.3M
Red Mountain Family Services, Inc.	NM	Foster Care Agency	$0	$22.7M
Phi Health, LLC	NM	Air Ambulance	$1.5M	$10.9M
Robben R. Gingery, Md, LLC	NM	Geriatric Psychiatry Physician	$0	$10.6M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$9.9M
Re-cycled Man LLC	NM	Community/Behavioral Health Agency	$0	$8M
New Mexico Wellness	NM	Community/Behavioral Health Agency	$0	$7.1M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$5.6M
Pinwheel Healing Center, LLC	NM	Community/Behavioral Health Agency	$0	$5.3M
Gd Psych Services, LLC	NM	Psychologist	$0	$4M

Four Winds Behavioral Health, Inc. — Billing Profile & Reimbursement Data

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Four Winds Behavioral Health, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References